I had almost back to back appointments with my therapist, then my psychiatrist. I thought we'd have time in between for a bite of lunch, but we had to wait until after the second appointment. My visit with my therapist was most pleasurable. Unlike my past therapists, I actually have true intellectual conversations with him. His English is more than good enough for them. I always feel good after seeing him, for that reason, primarily. Being so isolated, with Hubby only, it's nice to have someone to talk to at length. The issue is that he often goes overtime. Since Hubby waits for me at a cafe, I feel a bit bad. But better getting more time than too little.

Initially my husband joined me for my psychiatrist appointments, but a) I started to want to talk to the psychiatrist without him, and b) Hubby doesn't mind sitting at a restaurant nearby or walking around, as it is a lovely area. The only issue with seeing the pdoc alone is that he's always asking what Hubby thinks of my moods. Today, I think something I said (and how I said it) made him think I needed a medication increase. I was happy to stay where I was, and wasn't asking to have a lowered dose. Then he socks out the idea of maybe putting me on Abilify in addition to my other meds. I was like "WHAT?!?!" I told him that was not a good option. Really I didn't think any change was. He even brought up Lithium, for goodness sake! That would also be a disaster as it did little for me other than give me 10 side effects and eventual kidney and thyroid damage. But I could tell he was eager to make an addition, so I suggested going slightly up on my carbamazepine ER (Tegretol XR) from 600 mg to 800 mg. Luckily he agreed to that, and even ordered a carbamazepine level. So I have to go early tomorrow morning to get that done. I told him that my old psychiatrist hadn't ordered one in ages. Years, in fact.

I get the feeling that this new psychiatrist thinks I'm often a bit elevated in mood. My old psychiatrist used to also think that. Well, yes, I have bipolar disorder, but no, it's not always a cause for concern. I think they sometimes misinterpret the energy I exude. Especially when I haven't seen people, other than Hubby, for a while. But I did admit to him that a few days ago I put a shnitzer to a couple projects I created for myself. My food blogging plans were getting a little out of hand. So, I guess it was my fault. Nevertheless, I don't think an extra 200 mg of carbamazepine ER will do me much harm. Also, he wants me to split my increased dose between morning and evening. I had been taking the whole amount only at night. Splitting it may well be helpful, for both the higher and lower ends of my bipolar disorder. I have no major qualms with carbamazepine, at reasonable doses. The only ones I had were at 1,200 mg and 1,400 mg. Both made me quite clumsy. The 1,400 mg gave me double vision. My old pdoc lowered it all the way to 600 from 1,200 mg before I moved to Europe, after telling him I had fallen down stairs twice. Does anyone remember those injuries? Since then, so far so good. Then again, I've been staying only downstairs for months now, since our main bedroom was set up. I've probably only gone upstairs three or four times in the last three months. That's Hubby's territory.